Posted on Dec 09, 2020, 8 a.m.
Emotional health is inseparably linked to our hormones. Hormones are powerful substances, with even small quantities able to produce profound effects on health. Moods may be affected by many factors, including:
- Social and physical environment
- Sleep patterns
These factors are also connected to hormones, which regulate the brain’s response system and thereby determine moods. When hormonal conditions are unbalanced, emotions may become “out of whack.”
Sex Hormones, Mood Fluctuations, and Women’s Mental Health
Sex hormones play an important regulatory role in the sense of well-being. From puberty through menopause, women experience a continuous cycle of hormonal fluctuations that affect brain chemistry and, by extension, their moods. This physiological fact of life may partially explain why “depression and anxiety disorders are 2-3 more times more common in women than men,” according to Dr. Elizabeth Lee Vliet.
There is a “previously unrecognized connection between declining hormone levels in perimenopausal women and the high incidence of depression and anxiety disorders,” Dr. Vliet states. She reported on research conducted at Rockefeller University, which indicated that sex hormones are the most potent chemical signals affecting the brain. Changes in the levels of these hormones influence neurotransmitters (such as dopamine and serotonin), which in turn affect moods.
Dr. Vliet also reported on a Yale study, which concluded that hormone therapy over a six-month period appeared to result in an improvement in all categories of perimenopausal symptoms, including:
- Anxiety attacks
- Sleep disturbances
- Short-term memory problems
Mood Changes and Estrogen Imbalance
Estrogen levels have a domino effect on brain chemistry and moods. Aside from estrogen’s many roles in sexual and developmental health, it is also known to be a neuro-stimulant with anti-depressive effects. Dr. Phyllis Bronson states that “high levels of estrogen produce an imbalance in the system that aggravates or causes symptoms of tension and anxiety.”
Most women tend toward either estrogen dominance or estrogen deficiency, yet a woman will often experience both high and low levels due to hormonal fluctuations relative to her “normal” estrogen level. For instance, normal fluctuations occur during premenstrual syndrome (PMS), while perimenopause causes irregular fluctuations. During these fluctuations, women may experience mixed symptoms as their hormonal balance shifts.
Some women with high estrogen levels may be predisposed to anxiety and panic attacks. On the other hand, low levels of estrogen can lead to episodes of depression. Mood changes associated with a woman’s declining estrogen levels tend to respond well to estrogen therapy; upon receiving treatment, women often report feeling more alert and energetic.
Anxiety and Progesterone Deficiency
The estrogen-progesterone ratio may be the key to properly treating mood disorders. A study by Dr. Bronson found that “a deficiency of progesterone is clearly implicated as a primary factor in mid-life anxiety patterns.” She observed that when estrogen levels were high and progesterone levels low, patients “would exhibit extreme rage, followed by [a] conciliatory, self-defeating demeanor.”
The largest concentration of progesterone receptors is in the limbic area of the brain. This is the center of emotion and is also called the “area of rage and violence” by animal physiologists. Progesterone has a calming effect on the brain, suggesting that its deficiency may lead to anxiety.
Progesterone for PMS, Postnatal Depression, and Menopausal Mood Swings
Premenstrual syndrome and postnatal depression both may occur with a sudden drop in progesterone and may include considerable anxiety. Dr. Katharina Dalton found that these conditions may be effectively treated with progesterone, especially if administered before symptoms develop. For PMS, she suggested supplementing with progesterone from ovulation until menstruation; for preventing postnatal depression, she recommended beginning progesterone therapy immediately after delivery, tapering off until menstruation returns.
Dr. Bronson agrees that progesterone may be an effective treatment for anxiety in perimenopausal women. However, she found higher doses (specifically, 400-600mg daily administered on the skin) to be more effective, with most of her patients reporting significant improvements in emotional health. To achieve the best results in progesterone therapy, both Dr. Bronson and Dr. Dalton’s findings emphasize the importance of using bioidentical progesterone instead of synthetic progestins.
Stress and Thyroid Hormones
The thyroid gland produces several different hormones that have powerful and far-reaching consequences to health. The primary thyroid hormones are thyroxine (T4) and triiodothyronine (T3). These respond to pituitary thyroid-stimulating hormone (TSH) as part of the body’s complex system that regulates endocrine gland secretions.
Thyroid hormones affect every cell in the body in one way or another, including the parts of the body that regulate emotions. Thyroid deficiency inhibits the brain’s neurotransmitters, potentially leading to depression. Thyroid hormones also influence blood glucose levels and the release of stress hormones, two contributors to mood fluctuation.
Insulin, Glucose, and Dietary Factors in Mood Fluctuations
Dr. Dalton noticed a correlation between aggressive, emotional outbursts and blood sugar levels while treating women suffering from PMS. When asked about the time of day or circumstances immediately preceding such outbursts, her patients frequently reported that they occurred later in the morning after missing breakfast, or the evening while preparing a meal (especially if that was occurring later than usual). Many women also reported confusion or forgetfulness during the time surrounding these outbursts.
Paying careful attention to what and when you eat is important to emotional health. In Depression-Free for Life, Dr. Gabriel Cousens identifies foods according to a glycemic index, comparing their impact on blood sugar and mood. For example, eating foods that are high on the glycemic index (such as white flour products, refined and sweetened cereals, and candy bars) should be avoided, as they tend to cause “wild swings in blood sugar, a high followed by a low.”
Other Substances Affecting Mood
Many other hormones, amino acids, and nutrients also affect moods, making it difficult to diagnose mood disorders because each individual’s biochemistry has unique needs. We are still learning about how these substances work together to influence emotions. For example:
- Either too little or too much of the hormone melatonin can lead to depression,
- People with depression also often have elevated cortisol levels
- Amino acids (such as glutamine) can affect the neurotransmitters
- Nutrients such as vitamin B6 and other trace minerals also play an important role in regulating our moods
Because moods are complex, with a wide variety of possible causes or combinations of factors, symptoms of mood disorders may vary significantly from one person to the next and from one day to the next. The common approach of prescribing mind-altering medications may not be the best answer for everyone, particularly if any possible underlying hormonal imbalances are not addressed. However, emotional as well as physical health is a vital contributor to our quality of life, so it’s important to continue exploring how hormones affect mental and emotional well-being to help develop effective treatments for each patient’s needs.
This article was written by the staff at Women’s International Pharmacy, adapted from Moods and Emotions: Emotional Health and Well-Being Throughout the Life-Cycle A Connections Publication of Women’s International Pharmacy, and it was Edited by Michelle Violi, PharmD.
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This article is not intended to provide medical diagnosis, advice, treatment, or endorsement.
Bronson, PJ. Mood Biochemistry of Women at Mid-Life. Presentation
Dalton K. Depression After Childbirth. Oxford University Press; 1989.
Dalton K. Once a Month: The Original Premenstrual Syndrom Handbook. Hunter House Inc.; 1990.
Vliet EL. New insights on hormones and mood. Menopause Management. June/July 1993